Madrid, Spain – Researchers discussed an update on the latest evidence regarding the link between cancer and lifestyle as part of the Precision Health: Oncology session, held during the 7th International Congress of the Spanish Society for Precision Health (SESAP). The role that certain nutrients may play in tumor development has been analyzed, along with the latest data justifying the idea that a prescription for physical exercise should not be optional, but rather be integrated into tumor treatment.
“Diet and lifestyle can have an impact on each of the successive stages that occur in the carcinogenesis process: initiation, promotion, and progression. Although dietary factors and factors related to daily habits are more or less the same, their influence in each is the same,” explained the specialist. Nutrition and Nutrition Pedro Carrera Bastos, PhD candidate and researcher in Nutrition, Metabolism and Inflammation at Lund University, Sweden, says that the stage is different.” Carrera analyzed this question in his presentation “Diet and Habits in the Prevention of Carcinogenesis”.
“Deficiency of certain nutrients is one of the nutritional factors involved in the initiation phase, including folate and vitamins of group B (B12, B6, B3), which leads to chromosomal rupture, DNA methylation, and increased sensitivity to mutagens,” said Carrera. “As for vitamin C and selenium deficiencies, this increases oxidative DNA damage, an effect also associated with insufficient levels of zinc and magnesium and vitamin D deficiency.
“We have also seen that aflatoxin has a negative effect in the initiation stage. It is found in foods of plant origin, such as cassava, peppers, corn, millet, rice, sorghum, wheat, sunflower seeds or peanuts, although its effect depends largely on the way in which it is administered. Stock up on these foods,” Carrera added.
He explained that of all these factors, the most involved in this stage of carcinogenesis are nitrous compounds, nitrites, and nitrates in particular. “Substances that are naturally present in food do not cause cancer, because biochemically they do not produce nitrosamines. We have a problem with nitrites being added, for example, to processed meats or sausages; these produce nitrosamines.”
Polycyclic aromatic hydrocarbons
In the context of the association between nitrosamines and carcinogenesis, Carrera notes that these substances are also present in tobacco, although there are clear differences regarding their indirect effect. “In fact, when comparing the effects of tobacco with the effects of consuming processed meat, we see that 72% of lung cancer cases and 15% of all cancers are caused by the smoking habit, while eating processed meat is associated with 13% of bowel cancers and 1.5% of all cancers. “.
The specialist mentioned that there are two particularly harmful types of processed foods: cured meats (which contain N-nitroso compounds) and smoked meats and fish, which contain polycyclic aromatic hydrocarbons, which are chemicals directly related to certain cooking methods. “We know that PAHs are formed when foods of animal and vegetable origin are also cooked, since it is pyrolysis, whether from organic matter or from fats and proteins, that generates these substances.”
To illustrate the role played by different cooking methods, Carrera analyzed the results of a study conducted in China in which PAHs of animal and vegetable origin were compared when raw and after roasting. “The authors noted that the increase in PAHs was most significant in foods of animal origin. Likewise, they found that among meat, chicken is most susceptible to the formation of PAHs.”
The study also highlighted that it is possible to limit the formation of these substances by using different strategies. One strategy is to “soak the food in an acidic solution for more than one hour, during which the formation of these hydrocarbons is reduced, as well as the end products of advanced glycation, which are antioxidants and anti-inflammatory,” Carrera said. Another option is to season meat and fish before grilling (with pepper, paprika, garlic, onion, ginger, turmeric, cumin, cinnamon, cloves, fennel, anise), low heat (boiling is one of the most useful techniques) and above all Eat meat or fish with a large amount of vegetables, especially from the cabbage family (broccoli, cabbage, turnip, turnip, Brussels sprouts, mustard).
The goal: to stop the inflammation
Carrera explained the reasoning behind this recommendation. “Meats cooked on the grill may contain benzopyrene, a hydrocarbon that can cause DNA mutation, and is an indicator of carcinogenesis. At the same time, brassica is rich in sulforaphane, and is involved in overexpressing certain genes, among which are those that code for Express glutathione S-transferase, thus favoring benzopyrene elimination.”
There are many and varied factors that can act as triggers and precursors to carcinogenesis. Among them are psychological stress, circadian disruption (as shown by several studies regarding the effects of shift work), physical inactivity, obesity, hyperglycemia, hyperinsulinemia, and increased concentrations of insulin-like growth factor 1 (IGF-1)/which Insulin-like growth factor-binding protein 3 (IGFBP-3), dysbiosis, and vitamin D deficiency.
The common element or “guiding thread” of all these factors is inflammation, since we know about the active inflammatory response with different mechanisms, gene expression involved in apoptosis, increased angiogenesis, cellular proliferation, etc. “As we were able to verify in a study on this topic, among the main causes of chronic systemic inflammation, we find obesity, lack of physical activity, circadian rhythm disturbance, chronic psychological stress, exposure to various types of microorganisms or an inadequate diet,” said Carrera. . “All of this can activate many of the pathways that cause inflammation, which contributes to carcinogenesis.”
In parallel with the evidence for the role of inflammation in the stages of tumor promotion and progression, there is also more and more data about nutrients or lifestyle elements that can prevent or halt this effect. “One of the mentioned elements refers to omega-3 fatty acids (EPA, DHA), which can bind to a transmembrane receptor, preventing the activation of protein kinases,” said Carrera. “These acids are a solution, especially in patients with chronic low-level systemic inflammation. There are also several phytochemicals found in foods such as ginger, green tea, turmeric, broccoli and other brassica that can inhibit the phosphorylation of protein kinases. But what? It is important Really identifying the causes of chronic low-level inflammation in each patient and acting on them. That is the main goal. Likewise, lifestyle changes are much more relevant than thinking about nutrients or tangible substances, since it is daily and rituals that define our health. “.
Exercise as an oncology
At the same session, Adrián Castillo García, graduate of physical activity and sports science and researcher at the Barcelona Institute for Biomedical Research (IIBB) of the Spanish National Research Council (CSIC), reviewed the latest studies that showed evidence of the importance of physical therapy. Exercise during cancer treatment and its potential role in modulating tumor microenvironment and immune function.
In his presentation “Cancer and Exercise: A Battle Between High-Performing Cells,” the specialist commented on the links between exercise physiology and cancer physiology. He believes that this is an emerging field, which started over 10 years ago and there are still a lot of things to discover. “We should expand this field of study to provide the clinical reasons why physical exercise should be an essential treatment for patients with oncology,” Castillo said.
He continued, “Cancer is a disease with a clear metabolic component, and the tumor microenvironment partly determines disease progression and malignancy.” “In this framework, we know that hypoxia is one of the main drivers of tumor aggression, which leads to a vicious cycle that encourages protomer mutations. Therefore, it is essential to reduce hypoxia levels in fighting disease. The goal of any treatment is to modify the tumor microenvironment and to fight the tumor metabolically. With the goal of making treatments more effective.
“In this sense and according to preclinical study data, physical exercise may improve the efficacy of these treatments. Significantly, it has been shown to have the ability to modulate the tumor environment, reduce hypoxia and reduce the bioavailability of plasma lactate, a metabolite present in this microenvironment at elevated levels. This modified effect translates into an improvement in the effectiveness of chemotherapy and other oncology treatments.”
Castillo highlighted the results of one of the more recent studies on the topic, which showed that physical exercise, along with chemotherapy, reduces tumor progression and tumor size. The results position exercise as an important component of improving the main treatments being applied to these patients. “In addition, only studies in humans have shown (significantly, in the case of pancreatic cancer) that exercise remodels the structure of blood vessels, even when it is recommended (in small doses) that it be performed in the patient’s home.”
Regarding the most appropriate type of exercise to achieve this effect, in Castillo’s opinion, the best mitochondria that are “washers” of lactate are those associated with resistance exercise, such as cycling.
“Therefore, prescribing doses of physical activity of specific intensity and volume could be very critical in combating the tumor microenvironment, but this preliminary evidence must be confirmed in human trials to validate the role of exercise as a treatment capable of improving the efficacy of major treatments.”
Carrera and Castillo did not disclose any related financial relationships.
Follow Carla Nieto of Medscape Spanish Edition on Twitter: Tweet embed
This article was translated from Medscape Spanish Edition.
For more news, follow Medscape on Facebook, Twitterand Instagram and YouTube.